To Compare the Recurrence Rate of Strictures after Internal Optical Urethrotomy with Intralesional Injection of Mitomycin C versus without Mitomycin C Injection in Patients Presenting with Anterior Urethral Stricture

2021 ◽  
Vol 15 (10) ◽  
pp. 2856-2858
Author(s):  
Ismat Ullah ◽  
Muhammad Waqar Shahid ◽  
Muhammad Azeem Mughal ◽  
Rahat Usman

Background: The urethral strictures occurred due to narrowing of urethra. These may occur after an injury or ureteral or excretory system diseases, due to the injury to urothelium or corpus spongiosum that lead to the development of scar tissues. Mitomycin C can be used as chemotherapeutic agent because of its quality of being anti-tumour actions. Aim: To compare the recurrence rate of strictures after internal optical urethrotomy with intralesional injection of Mitomycin C versus without Mitomycin C injection in patients presenting with anterior urethral stricture. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Urology, Lahore General Hospital, Lahore from 5th September 2016 to 5th March 2017. Methodology: Sixty male patients age 18-70 years, diagnosed with anterior (penile and bulbar) urethral stricture up to 2.0cm were included. Patients were randomly divided into two groups; Group A patients were treated with internal optical urethrotomy alone and Group B patients treated with internal optical urethrotomy with intralesional injection of Mitomycin C. After the procedure, an 18F or 20F indwelling catheter left for 7 days. After 6 months, surgical site evaluated and if stricture again developed, then recurrence labeled. Results: The mean age was 39.32±11.38 years, mean duration of stricture was 6.85±3.32 months and the mean stricture size was 1.21±0.45 cm. The recurrence occurred in 18 (30%) patients. Significant difference was noted for recurrence in both groups (p-value<0.05). Conclusion: The recurrence rate with anterior urethral stricture is significantly lower in with Mitomycin C as compared to without Mitomycin C. Keywords: Recurrence, Urethral stricture, Mitomycin C

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Santosh Kumar ◽  
Nitin Garg ◽  
Shrawan Kumar Singh ◽  
Arup Kumar Mandal

Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture.Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40 mg, mitomycin C 2 mg, and hyaluronidase 3000 in 5–10 mL of saline according to length of stricture. An indwelling 18 Fr silicone catheter was left in place for a period of 7–21 days. All patients were followed up for 6–18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months.Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients), that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients), that is, a success rate of 94.2%.Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures.


2021 ◽  
Vol 15 (8) ◽  
pp. 1852-1854
Author(s):  
Aneeque Alam Khan ◽  
Kiran Mehwish ◽  
Ravi Kumar ◽  
Pavan Kumar ◽  
Tahir Ali ◽  
...  

Aim: To compare the frequency of absence of pain with injection paracetamol versus placebo given before injection rocuronium in patients undergoing elective procedures Study design: Randomized Controlled Trial Place and duration of study: Dept of Anaesthesia, Civil Hospital, Karachi from 15th January to 14th July 2017. Methodology: One hundred and two patients aged 25-75 years of either gender undergoing elective surgery were enrolled. The lottery method was used to divide the patients into two equal groups. Paracetamol (5 mL, 10 mg/mL) or normal saline (5 mL) were used as pretreatment solutions. When the tourniquet was removed after 2 minutes, the rocuronium at 1% concentration was injected throughout the 10 second’s period. Patients were then advised and asked to rate their pain on the hand's dorsum using VAS. Results: Mean age of the patients was 44.11±7.75 years. Mean pain score was 1.49±1.38. Significant difference was observed in the mean pain score in between paracetamol and placebo group (p-value <0.001). Overall absence of pain was found in 49 (40.8%). Absence of pain was found to be higher 34 (69.4%) in paracetamol group as compared to placebo group (p-value <0.001). Conclusion: Frequency of absence of pain found lower in patients undergoing elective procedures with injection paracetamol versus placebo given before injection rocuronium. Keywords: Injection rocuronium, Elective procedures, Injection paracetamol, Absence of pain


Author(s):  
Amalina T. Susilani ◽  
Hertanto W. Subagio ◽  
Noor Pramono ◽  
Martha I. Kartasurya

Background: Pregnant women are among the groups at high risk of vitamin D3 deficiency due to the increased need for micro and macro nutrients during pregnancy. Vitamin D3 deficiency is associated with pregnancy complications, namely preterm birth, pre-eclampsia, gestational diabetes, and babies born small according to their gestational age.Methods: The study involved a randomized pretest-posttest control group design. Subjects selected include 80 pregnant women in second trimester. Data were collected in June 2020 to September 2020. The respondents were then randomly divided into 2 groups, comprising 40 each, where the first received 400 IU/day vitamin D3 supplementation for 12 weeks, and the second served as a control. Furthermore, 25 (OH) D were measured by using the ELISA method.Results: The mean value of the 25(OH)D levels after D3 supplementation and statistically showed a significant difference with a significance value of p<0.05 (0.01), compared to the control group.  Furthermore, the mean value of the 25(OH)D levels in the control group actually decreased by 2.7 ng/ml which was statistically significant with a p value of 0.00, compared to the control group. Furthermore, the mean value of the 25(OH)D levels in the control group actually decreased by 2.7 ng/ml which was statistically significant with a p value of 0.00.Conclusions: Vitamin D3 supplement of 400 IU per day can increase the levels of 25(OH)D in the II and III trimester of pregnant women in antenatal care (ANC), Sleman Regency, Yogyakarta.


Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.


Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 358
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Nansi López-Valverde ◽  
Francisco Martínez-Martínez ◽  
Juan Manuel Aragoneses

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.


Author(s):  
Priyanka Jain ◽  
Rakesh Jain

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.


2021 ◽  
Vol 15 (12) ◽  
pp. 3195-3197
Author(s):  
Fariha Sadiqa ◽  
Mufakhara Fatimah ◽  
Abdul Mudabbir Rehan ◽  
Sidra Mushtaq ◽  
Asia Firdous ◽  
...  

Background: Pelvic pain around the time of mensturation without any identifiable pathologic lesion present from menarche is called primary dysmenorrhea. The pain is believed to be related to prostaglandin (PG). Women with dysmenorrhoea have a relatively high concentration of PGF 2 alpha in menstrual fluid and suppression of PG synthesis has become the main treatment. Aim: To compare mean reduction in pain in patients presenting with primary dysmenorrhea given vitamin E & Mefenamic acid versus Mefenamic acid alone. Results: It was a randomized controlled trial which was conducted in Department of Obstetrics & Gynecology, THQ Raiwind Hospital, Lahore for 6 months duration w.e.f 01/02/2017 to 31/07/2017. In this study, 18(36%) in Vitamin-E group and 21(42%) in Mefenamic acid group were between 15-20 years while 32(64%) in Vitamin-E group and 29(58%) in Mefenamic acid group were between 21-25 years, mean±sd was calculated as 20.86±2.92 and 20.66±2.86 years respectively, mean dysmenorrheal pain at baseline was recorded as 50.06±10.27 in Vitamin-E group and 50.14±10.28 in Mefenamic acid group, p value < 0.754, showing that both groups are insignificant, mean dysmenorrheal pain after treatment was recorded as 20.50±10.04 in Vitamin-E group and 30.22±10.28 in Mefenamic acid group, p value was < 0.002 showing significant difference between the two group, comparison of mean reduction in dysmenorrheal pain after treatment was recorded as 20.56±0.91 in Vitamin-E group and 10.92±0.75 in Mefenamic acid group, p value was < 0.000, showing significant difference. Conclusion: We concluded that there is a significant mean reduction in dysmenorrhic pain in patients given Mefenamic Acid + Vitamen E as compared to patients given Mefenamic Acid alone. Keywords: Dysmenorrhic pain, Mefenamic Acid + Vitamen E, mean reduction in dysmenorrhic pain


2021 ◽  
Vol 104 (5) ◽  
pp. 695-700

Objective: To compare the effects of immediate versus delayed cord clamping on neonatal outcomes in preterm neonates of gestational age of 32 to 36⁺⁶ weeks, and maternal outcomes. Materials and Methods: A randomized controlled trial was conducted in the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, in Bangkok, Thailand. The study compared the effects of immediate to delayed cord clamping at 60 seconds among preterm neonates born between 32 weeks, 0 day and 36 weeks, 6 days of gestation between August and October 2018. Results: The mean age of the participants was 26 years old, and half of the cases were nulliparous. One hundred ten women were randomly separated into two equal groups (n=55). Delayed cord clamping at 60 seconds increased hematocrit levels (Hct) in both two (p=0.004) and 48 (p<0.001) hours after delivery compared to the immediate cord clamping group. There were no differences in exposing the neonate to hypothermia, hypoxemia, Apgar score at 1-minute, polycythemia, intraventricular hemorrhage, hyperbilirubinemia, length of stay in hospital, and affecting the process of resuscitation. There were no statistical differences between the two groups in maternal outcomes such as retained placenta and postpartum hemorrhage. Conclusion: Delayed cord clamping at 60 seconds increased Hct in the newborn at two to 48 hours after birth. There was no significant difference in adverse maternal and neonatal complications within both groups. Keywords: Delayed cord clamping, Hematocrit, Preterm


Author(s):  
Muhammad Kashif ◽  
Nosheen Manzoor ◽  
Rimsha Safdar ◽  
Hafsa Khan ◽  
Maryam Farooq ◽  
...  

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.


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